Barr told an appeals court that he does not want it to merely murder that one provision but, instead, will insist that it massacre the ACA’s entire 1,990 pages—death to every clause protecting patients from insurance company abuses, every portion devoted to containing costs, every phrase extending health care to the nation’s young adults and working poor.

It is essential, Barr contends, that the court rip insurance from 21 million people covered by the ACA health insurance marketplaces and Medicaid expansion; that the court deny insurance to 2 million young adults covered by their parents’ plans; that the court foreclose substance abuse treatment to 800,000 Americans suffering opioid addiction.

It is critical, Barr insists, to deprive the ACA’s guarantee of medical insurance access to 133 million Americans with pre-existing conditions and to increase medication and premium costs for 60 million senior citizens on Medicare. Also, of course, Barr says, the court must restore the medical insurance caps that bankrupted and killed Americans who suffered diseases that are expensive to treat, like cancer, or whose babies were born prematurely requiring costly long-term care.

Barr is not an outlier. He is the face of a Republican Party that has done everything in its power to rob Americans of ACA benefits every minute of the nine years that the law has existed.

Barr is not an outlier. He is the face of a Republican Party that has done everything in its power to rob Americans of ACA benefits every minute of the nine years that the law has existed. GOP governors have vetoed the ACA extension of Medicaid, denying insurance to millions of low-income working people. When the U.S. House was controlled by the GOP, it voted more than 50 times to repeal all or parts of the ACA. Twenty GOP state attorneys general asked a federal judge to overturn the law after Congress zeroed out its tax penalties for people who refuse to get insurance.

All of this is blatantly mean-spirited because the GOP never produced a plan to replace the ACA health insurance guarantees. In medical terms, it is the opposite of the physician mission to heal. It is Republican machination to harm.

People who drive a Mercedes, spend half a million bucks to get their children into high-status universities and lull away weekends at $3 million Nantucket beach homes will always have health care. The price is irrelevant to them. Even if denied insurance, they can afford chemotherapy, or the monthly bill for insulin or the cost of a leg broken in a sail-boating accident.

For everyone else, for coal miners and code writers, for registered nurses and Starbucks baristas, for Amazon warehouse workers and independent truck drivers, health insurance is vital. Workers, whether low-income or middle class, don’t have hundreds of thousands sitting around for a heart transplant or repeated cancer treatments or neonatal care.

Uninsured people died of treatable conditions because they couldn’t afford care. Inadequate insurance bankrupted families. Americans worried incessantly about whether they would be able to afford to maintain their insurance or whether an illness would cost them their coverage.

The position of Republicans, however, is that some people just don’t deserve health insurance. It’s similar to saying some children just don’t deserve an education. Or some families just don’t deserve to have a fire department respond to a blaze at their home.

As a result, Republican governors and lawmakers denied Medicaid to millions of eligible low-income working people and their families. Some Republican governors went so far as to defy the will of the people of their states. In Maine, for example, voters approved expanding Medicaid in 2017 in a binding referendum by 59-to-41 percent after the Republican governor five times vetoed Medicaid expansion proposals. Even after the referendum and a court decision ordering expansion, the Republican governor refused to do it. Not until a Democrat took the governor’s seat this year did it happen. Similarly, Virginia and Kansas got Medicaid extensions only after they elected Democratic governors.

They probably will appeal—at the same time Republican Attorney General Barr is trying to blow up the entire health care law. The message is clear: to Republicans, health care is a right only for the rich; the rest can suffer and die. The GOP Hippocratic oath is: Do vast harm.

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Leo Gerard, is the International President of the United Steelworkers (USW) union and is the second Canadian to head the union. He is also a vice president of the AFL-CIO. Gerard is co-chairman of the BlueGreen Alliance and on the boards of Campaign for America’s Future and the Economic Policy Institute.

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A belated, heartfelt happy birthday to Harvey Milk, assassinated in 1978 for daring to come out of the closet, be himself and insist on his rights, who would have turned 89 this week. On Harvey Milk Day, California passed a resolution honoring his "critical role in creating the modern LGBT movement." From one ally: "He imagined a righteous world inside his head and then he set about to create it." These dark days, his message resonates more than ever: "You stand up and fight."

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